Feedback is often reported to be a weakness in surveys of student experiences. This is a complex area and it is possible that the answers conceal some other message, and that students’ understanding of feedback is different from teachers’. But feedback may have deteriorated.
The photo shows staff of the Dept Medicine reviewing students at the end of their 8 week attachment at Queen Elizabeth Central Hospital Blantyre (College of Medicine, University of Malawi). Sessions like this occurred in Edinburgh in the ‘old’ curriculum, but now seem to be a rarity. Why?
- Students have more numerous, shorter attachments than they used to, as specialties have become narrower and more numerous
- Doctors are more numerous and rotate faster and work shifts, so doctors (especially junior doctors) are less likely to get to know students well
- It is difficult to find time to have meetings like this this as doctors’ working hours have become tightly regulated and shifts mean they aren’t all there at one time
Making students integral
Probably won’t fix the whole feedback issue but can’t be a bad thing?
When units don’t know their students so well, they are less likely to trust and rely on them. In Malawi students are important to patient care. In the UK, until the recent piloting of Assistantships as a rather small part of Final Year, students had been largely relieved of a real clinical role. The ethos was that they were there to be taught, not to provide service. The pendulum had swung away from them having a core role for fear that patients would come to harm.
It would be crazy to suggest that Malawi has got it all right, as their shortage of doctors and healthcare resources is severe – but despite that, they have time for this. They have realised that it is in their interests, indeed, as they rely on their students so much. It behoves us to look again at our own practice. How can we make students more involved and part of the team again in our resource-rich environment? A number of approaches have been suggested, but what do you think?